Combined effect of anterior malocclusion and inadequate lip coverage on dental trauma in primary teeth

Objectives: The main objective of this study was to investigate whether the interaction of malocclusion (open bite or increased overjet) combined with inadequate lip coverage strengthens its association with traumatic dental injury (TDI) in the primary teeth of preschool children compared to the presence of malocclusion alone. Subjects and methods: A cross-sectional survey was conducted with 376 children aged 3659 months who attended the National Day of Childrens Vaccination. Presence of TDI, tooth discoloration, and sinus tract were evaluated in the children. Variables associated with occlusion were also evaluated. A Poisson regression analysis was performed to verify the association between the explanatory variables and TDI as well as possible interactions among the variables. Then, the prevalence ratio was calculated. Results: The prevalence of TDI was 27.7%. The maxillary central incisor was the most affected tooth, without differences between the right and left sides. Boys had more dental trauma than girls (P = 0.04). The most common TDI was crown fracture restricted to the enamel (58.4%). Children with a combination of anterior open bite or increased overjet and inadequate lip coverage presented a higher prevalence of TDI than when the malocclusions were presented alone (P < 0.05). The same trends were observed when we included, in the final adjusted model, increased overjet instead of open bite. Conclusions: Anterior malocclusions of primary teeth such as increased overjet and anterior open bite are statistically significantly associated with dental trauma only when inadequate lip coverage is also present.

Exercise training program based on minimum weekly frequencies: effects on blood pressure and physical fitness in elderly hypertensive patients

Background: Exercise training (ET) can reduce blood pressure (BP) and prevent functional disability. However, the effects of low volumes of training have been poorly studied, especially in elderly hypertensive patients. Objectives: To investigate the effects of a multi-component ET program (aerobic training, strength, flexibility, and balance) on BP, physical fitness, and functional ability of elderly hypertensive patients. Methods: Thirty-six elderly hypertensive patients with optimal clinical treatment underwent a multi-component ET program: two 60-minute sessions a week for 12 weeks at a Basic Health Unit. Results: Compared to pre-training values, systolic and diastolic BP were reduced by 3.6% and 1.2%, respectively (p < 0.001), body mass index was reduced by 1.1% (p < 0.001), and peripheral blood glucose was reduced by 2.5% (p= 0.002). There were improvements in all physical fitness domains: muscle strength (chair-stand test and elbow flexor test; p < 0.001), static balance test (unipedal stance test; p < 0.029), aerobic capacity (stationary gait test; p < 0.001), except for flexibility (sit and reach test). Moreover, there was a reduction in the time required to perform two functional ability tests: "put on sock" and "sit down, stand up, and move around the house" (p < 0.001). Conclusions: Lower volumes of ET improved BP, metabolic parameters, and physical fitness and reflected in the functional ability of elderly hypertensive patients. Trial Registration RBR-2xgjh3.

On reducing test length for FSMs with extra states

A long-standing problem when testing from a deterministic finite state machine is to guarantee full fault coverage even if the faults introduce extra states in the implementations. It is well known that such tests should include the sequences in a traversal set which contains all input sequences of length defined by the number of extra states. This paper suggests the SPY method, which helps reduce the length of tests by distributing sequences of the traversal set and reducing test branching. It is also demonstrated that an additional assumption about the implementation under test relaxes the requirement of the complete traversal set. The results of the experimental comparison of the proposed method with an existing method indicate that the resulting reduction can reach 40%. Experimental results suggest that the additional assumption about the implementation can help in further reducing the test suite length. Copyright (C) 2011 John Wiley & Sons, Ltd.

Transverse sphericity of primary charged particles in minimum bias proton-proton collisions at root s=0.9, 2.76 and 7 TeV

Measurements of the sphericity of primary charged particles in minimum bias proton-proton collisions at root s = 0.9, 2.76 and 7 TeV with the ALICE detector at the LHC are presented. The observable is measured in the plane perpendicular to the beam direction using primary charged tracks with p(T) > 0.5 GeV/c in vertical bar eta vertical bar < 0.8. The mean sphericity as a function of the charged particle multiplicity at mid-rapidity (N-ch) is reported for events with different p(T) scales ("soft" and "hard") defined by the transverse momentum of the leading particle. In addition, the mean charged particle transverse momentum versus multiplicity is presented for the different event classes, and the sphericity distributions in bins of multiplicity are presented. The data are compared with calculations of standard Monte Carlo event generators. The transverse sphericity is found to grow with multiplicity at all collision energies, with a steeper rise at low N-ch, whereas the event generators show an opposite tendency. The combined study of the sphericity and the mean p(T) with multiplicity indicates that most of the tested event generators produce events with higher multiplicity by generating more back-to-back jets resulting in decreased sphericity (and isotropy). The PYTHIA6 generator with tune PERUGIA-2011 exhibits a noticeable improvement in describing the data, compared to the other tested generators.

The 3C cooperation model applied to the classical requirement analysis

Aspects related to the users' cooperative work are not considered in the traditional approach of software engineering, since the user is viewed independently of his/her workplace environment or group, with the individual model generalized to the study of collective behavior of all users. This work proposes a process for software requirements to address issues involving cooperative work in information systems that provide distributed coordination in the users' actions and the communication among them occurs indirectly through the data entered while using the software. To achieve this goal, this research uses ergonomics, the 3C cooperation model, awareness and software engineering concepts. Action-research is used as a research methodology applied in three cycles during the development of a corporate workflow system in a technological research company. This article discusses the third cycle, which corresponds to the process that deals with the refinement of the cooperative work requirements with the software in actual use in the workplace, where the inclusion of a computer system changes the users' workplace, from the face to face interaction to the interaction mediated by the software. The results showed that the highest degree of users' awareness about their activities and other system users contribute to a decrease in their errors and in the inappropriate use of the system.

A Galactic ring of minimum stellar density near the solar orbit radius

We analyse the secular effects of a long-lived Galactic spiral structure on the stellar orbits with mean radii close to the corotation resonance. By test-particle simulations and different spiral potential models with parameters constrained on observations, we verified the formation of a minimum with amplitude ∼30–40 per cent of the background disc stellar density at corotation. Such a minimum is formed by the secular angular momentum transfer between stars and the spiral density wave on both sides of corotation. We demonstrate that the secular loss (gain) of angular momentum and decrease (increase) of mean orbital radius of stars just inside (outside) corotation can counterbalance the opposite trend of exchange of angular momentum shown by stars orbiting the librational points L4/5 at the corotation circle. Such secular processes actually allow steady spiral waves to promote radial migration across corotation. We propose some pieces of observational evidence for the minimum stellar density in the Galactic disc, such as its direct relation to the minimum in the observed rotation curve of the Galaxy at the radius r ∼ 9 kpc (for R0 = 7.5 kpc), as well as its association with a minimum in the distribution of Galactic radii of a sample of open clusters older than 1Gyr. The closeness of the solar orbit adius to the corotation resonance implies that the solar orbit lies inside a ring of minimum surface density (stellar + gas). This also implies a correction to larger values for the estimated total mass of the Galactic disc, and consequently, a greater contribution of the disc componente to the inner rotation curve of the Galaxy.

The role of the NadR regulator during infection and its implication for the coverage of a new Meningococcus B vaccine

Background: Neisseria meningitides represents a major cause of meningitis and sepsis. The meningococcal regulator NadR was previously shown to repress the expression of the Neisserial Adhesin A (NadA) and play a major role in its phase-variation. NadA is a surface exposed protein involved in epithelial cell adhesion and colonization and a major component of 4CMenB, a novel vaccine to prevent meningococcus serogroup B infection. The NadR mediated repression of NadA is attenuated by 4-HPA, a natural molecule released in human saliva. Results: In this thesis we investigated the global role of NadR during meningogoccal infection, identifying through microarray analysis the NadR regulon. Two distinct types of NadR targets were identified, differing in their promoter architectures and 4HPA responsive activities: type I are induced, while type II are co-repressed in response to the same 4HPA signal. We then investigate the mechanism of regulation of NadR by 4-HPA, generating NadR mutants and identifying classes or residues involved in either NadR DNA binding or 4HPA responsive activities. Finally, we studied the impact of NadR mediated repression of NadA on the vaccine coverage of 4CMenB. A selected MenB strains is not killed by sera from immunized infants when the strain is grown in vitro, however, in an in vivo passive protection model, the same sera protected infant rats from bacteremia. Finally, using bioluminescent reporters, nadA expression in the infant rat model was induced in vivo at 3 h post-infection. Conclusions: Our results suggest that NadR coordinates a broad transcriptional response to signals present in the human host, enabling the meningococcus to adapt to the relevant host niche. During infectious disease the effect of the same signal on NadR changes between different targets. In particular NadA expression is induced in vivo, leading to efficient killing of meningococcus by anti-NadA antibodies elicited by the 4CMenB vaccine.

Evaluation of slope stability under water and seismic load through the Minimum Lithostatic Deviation method

The main objective of this thesis is to obtain a better understanding of the methods to assess the stability of a slope. We have illustrated the principal variants of the Limit Equilibrium (LE) method found in literature, focalizing our attention on the Minimum Lithostatic Deviation (MLD) method, developed by Prof. Tinti and his collaborators (e.g. Tinti and Manucci, 2006, 2008). We had two main goals: the first was to test the MLD method on some real cases. We have selected the case of the Vajont landslide with the objective to reconstruct the conditions that caused the destabilization of Mount Toc, and two sites in the Norwegian margin, where failures has not occurred recently, with the aim to evaluate the present stability state and to assess under which conditions they might be mobilized. The second goal was to study the stability charts by Taylor and by Michalowski, and to use the MLD method to investigate the correctness and adequacy of this engineering tool.

Computer Aided Surgery for Percutaneous Nephrolithotomy: Clinical Requirement Analysis and System Design

Percutaneous nephrolithotomy (PCNL) for the treatment of renal stones and other related renal diseases has proved its efficacy and has stood the test of time compared with open surgical methods and extracorporal shock wave lithotripsy. However, access to the collecting system of the kidney is not easy because the available intra-operative image modalities only provide a two dimensional view of the surgical scenario. With this lack of visual information, several punctures are often necessary which, increases the risk of renal bleeding, splanchnic, vascular or pulmonary injury, or damage to the collecting system which sometimes makes the continuation of the procedure impossible. In order to address this problem, this paper proposes a workflow for introduction of a stereotactic needle guidance system for PCNL procedures. An analysis of the imposed clinical requirements, and a instrument guidance approach to provide the physician with a more intuitive planning and visual guidance to access the collecting system of the kidney are presented.

Benchmarking in the SWISSspine registry: results of 52 Dynardi lumbar total disc replacements compared with the data pool of 431 other lumbar disc prostheses

The SWISSspine registry is the first mandatory registry of its kind in the history of Swiss orthopaedics and it follows the principle of "coverage with evidence development". Its goal is the generation of evidence for a decision by the Swiss federal office of health about reimbursement of the concerned technologies and treatments by the basic health insurance of Switzerland. Recently, developed and clinically implemented, the Dynardi total disc arthroplasty (TDA) accounted for 10% of the implanted lumbar TDAs in the registry. We compared the outcomes of patients treated with Dynardi to those of the recipients of the other TDAs in the registry. Between March 2005 and October 2009, 483 patients with single-level TDA were documented in the registry. The 52 patients with a single Dynardi lumbar disc prosthesis implanted by two surgeons (CE and OS) were compared to the 431 patients who received one of the other prostheses. Data were collected in a prospective, observational multicenter mode. Surgery, implant, 3-month, 1-year, and 2-year follow-up forms as well as comorbidity, NASS and EQ-5D questionnaires were collected. For statistical analyses, the Wilcoxon signed-rank test and chi-square test were used. Multivariate regression analyses were also performed. Significant and clinically relevant reduction of low back pain and leg pain as well as improvement in quality of life was seen in both groups (P < 0.001 postop vs. preop). There were no inter-group differences regarding postoperative pain levels, intraoperative and follow-up complications or revision procedures with a new hospitalization. However, significantly more Dynardi patients achieved a minimum clinically relevant low back pain alleviation of 18 VAS points and a quality of life improvement of 0.25 EQ-5D points. The patients with Dynardi prosthesis showed a similar outcome to patients receiving the other TDAs in terms of postoperative low back and leg pain, complications, and revision procedures. A higher likelihood for achieving a minimum clinically relevant improvement of low back pain and quality of life in Dynardi patients was observed. This difference might be due to the large number of surgeons using other TDAs compared to only two surgeons using the Dynardi TDA, with corresponding variations in patient selection, patient-physician interaction and other factors, which cannot be assessed in a registry study.

Heterogeneity in vaccination coverage explains the size and occurrence of measles epidemics in German surveillance data

The objective of this study was to characterize empirically the association between vaccination coverage and the size and occurrence of measles epidemics in Germany. In order to achieve this we analysed data routinely collected by the Robert Koch Institute, which comprise the weekly number of reported measles cases at all ages as well as estimates of vaccination coverage at the average age of entry into the school system. Coverage levels within each federal state of Germany are incorporated into a multivariate time-series model for infectious disease counts, which captures occasional outbreaks by means of an autoregressive component. The observed incidence pattern of measles for all ages is best described by using the log proportion of unvaccinated school starters in the autoregressive component of the model.

Symptomatic spinal cord malperfusion after stent-graft coverage of the entire descending aorta

The study aims to identify risk constellations for symptomatic spinal cord malperfusion in patients undergoing extensive stent-graft coverage of the thoracic aorta.

Global Search for Minimum Energy (H2O)n Clusters, n = 3−5

The Gaussian-3 (G3) model chemistry method has been used to calculate the relative ΔG° values for all possible conformers of neutral clusters of water, (H2O)n, where n = 3−5. A complete 12-fold conformational search around each hydrogen bond produced 144, 1728, and 20 736 initial starting structures of the water trimer, tetramer, and pentamer. These structures were optimized with PM3, followed by HF/6-31G* optimization, and then with the G3 model chemistry. Only two trimers are present on the G3 potential energy hypersurface. We identified 5 tetramers and 10 pentamers on the potential energy and free-energy hypersurfaces at 298 K. None of these 17 structures were linear; all linear starting models folded into cyclic or three-dimensional structures. The cyclic pentamer is the most stable isomer at 298 K. On the basis of this and previous studies, we expect the cyclic tetramers and pentamers to be the most significant cyclic water clusters in the atmosphere.